Proteinuria Follow-up

  • Author: Edgar V Lerma, MD, FACP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FACP, FASN   more...
 
Updated: Jan 31, 2012
 

Further Inpatient Care

  • Inpatient care is necessary only if the patient develops complications of severe nephrotic syndrome.
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Further Outpatient Care

  • Patients may require regular follow-up care by a family physician, general internal medicine specialist, or nephrologist, depending on the cause and setting of proteinuria.
  • Monitoring of proteinuria, the presence or absence of other indicators of renal disease, complications of nephrotic syndrome, treatment effectiveness, and adverse effects is required.
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Transfer

  • If patients are not monitored by a nephrologist, transfer to a nephrologist is indicated if the patient develops proteinuria, any adverse prognostic markers (eg, rise in albumin excretion of > 1 g/d), or any worsening in renal function.
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Complications

  • Pulmonary edema due to fluid overload
  • Acute renal failure due to intravascular depletion
  • Increased risk of bacterial infection, including spontaneous bacterial peritonitis
  • Increased risk of arterial and venous thrombosis, including renal vein thrombosis
  • Increased risk of cardiovascular disease
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Prognosis

  • The prognosis depends on the cause, duration, and degree of proteinuria.
  • Young adults with transient or orthostatic proteinuria have a benign prognosis.
  • Patients with hypertension and microalbuminuria (or higher degrees of albuminuria) have a significantly increased risk of cardiovascular disease.
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Contributor Information and Disclosures
Author

Edgar V Lerma, MD, FACP, FASN, FAHA  Clinical Associate Professor of Medicine, Section of Nephrology, Department of Medicine, University of Illinois at Chicago College of Medicine; Research Director, Internal Medicine Training Program, Advocate Christ Medical Center; Consulting Staff, Associates in Nephrology, SC

Edgar V Lerma, MD, FACP, FASN, FAHA is a member of the following medical societies: American Heart Association, American Medical Association, American Society of Hypertension, American Society of Nephrology, Chicago Medical Society, Illinois State Medical Society, National Kidney Foundation, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Kevin McLaughlin  MB, ChB, MSc, PhD, Associate Professor, Assistant Dean, Department of Medicine, University of Calgary Faculty of Medicine, Calgary Health Region

Kevin McLaughlin is a member of the following medical societies: American Society of Nephrology, American Society of Transplantation, and College of Physicians and Surgeons of Alberta

Disclosure: Nothing to disclose.

Specialty Editor Board

Frank C Brosius III, MD  Nephrology Program Director, Professor of Internal Medicine and Physiology, Department of Internal Medicine, Division of Nephrology, University of Michigan School of Medicine

Frank C Brosius III, MD is a member of the following medical societies: Alpha Omega Alpha, American Diabetes Association, American Society of Nephrology, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

George R Aronoff, MD  Director, Professor, Departments of Internal Medicine and Pharmacology, Section of Nephrology, Kidney Disease Program, University of Louisville School of Medicine

George R Aronoff, MD is a member of the following medical societies: American Federation for Medical Research, American Society of Nephrology, Kentucky Medical Association, and National Kidney Foundation

Disclosure: Nothing to disclose.

Rebecca J Schmidt, DO, FACP, FASN  Professor of Medicine, Section Chief, Department of Medicine, Section of Nephrology, West Virginia University School of Medicine

Rebecca J Schmidt, DO, FACP, FASN is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Nephrology, International Society of Nephrology, National Kidney Foundation, Renal Physicians Association, and West Virginia State Medical Association

Disclosure: Renal Ventures Ownership interest Other

Chief Editor

Vecihi Batuman, MD, FACP, FASN  Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Medicine Service, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, and International Society of Nephrology

Disclosure: Nothing to disclose.

References

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